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目的:探讨完全性右束支传导阻滞(CRBBB)并左前分支传导阻滞(LAFB)的T环形态及异常的临床价值。方法:对正常人(对照组)和陈旧性心肌梗死患者(OMI组)各50例及心电图(ECG)符合CRBBB加LAFB诊断(CRBBB加LAFB组)84例行心电向量图(VCG)检查。根据临床资料CRBBB加LAFB组分为无器质性心脏病的正常亚组(A组,39例)和有器质性心脏病的异常亚组(B组,45例)。分析T向量环改变及临床意义。结果:对照组T环形态多呈狭长型,占96%(48/50);OMI组T环多呈圆小型、狭小型和圆长型,占94.0%(47/50),2组比较差异有统计学意义(P<0.05)。CRBBB加LAFB组:A组T环形态呈狭长型94.9%(37/39);B组T环形态呈圆小型、狭小型和圆长型占84.4%(38/45),2组比较差异有统计学意义(P<0.05)。而A组与对照组比较差异无统计学意义(P>0.05)。结论:CRBBB加LAFB者VCG示T环呈圆小型、狭小型与心肌缺血有关,T环呈狭长型可能为传导系统原发性退行性变所致。
Objective: To investigate the clinical value of T-ring morphology and abnormalities of complete right bundle branch block (CRBBB) and left anterior branch block (LAFB). Methods: Fifty-eight patients (control group) and 50 patients with old myocardial infarction (OMI group) and 84 patients with electrocardiogram (ECG) who underwent CRBBB plus LAFB diagnosis (CRBBB plus LAFB group) According to clinical data CRBBB plus LAFB components were normal subgroup without organic heart disease (group A, 39 cases) and abnormal subgroup with organic heart disease (group B, 45 cases). Analysis of T vector ring changes and clinical significance. Results: The shape of T-ring in the control group was mostly long and narrow, accounting for 96% (48/50). The T-ring in OMI group was mostly round, small and round, accounting for 94.0% (47/50) There was statistical significance (P <0.05). In CRBBB plus LAFB group, the T-ring morphology of group A was elongated (94.9%, 37/39). The shape of T-ring in group B was round and small, with 84.4% (38/45) in narrow and round shape, Statistical significance (P <0.05). There was no significant difference between A group and control group (P> 0.05). CONCLUSION: The VCG of CRBBB plus LAFB showed that the T-ring was round and small, and the mini-type was related to myocardial ischemia. The long and narrow T-ring was probably caused by the primary degenerative changes of the conduction system.